Increasing trend in emergency department visits for hypoglycemia from patients with type 2 diabetes mellitus in Taiwan

2015 ◽  
Vol 9 (6) ◽  
pp. 490-496 ◽  
Author(s):  
Ying-Ju Chen ◽  
Chen-Chang Yang ◽  
Lynn-Chu Huang ◽  
Likwang Chen ◽  
Chii-Min Hwu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Emergency Department ◽  
Type 2 Diabetes Mellitus ◽  
Emergency Department Visits ◽  
Increasing Trend

scholarly journals Economic evaluation of outpatients with type 2 diabetes mellitus assisted by a pharmaceutical care service

2011 ◽  
Vol 55 (9) ◽  
pp. 686-691 ◽  
Author(s):  
Anna Paula de Sá Borges ◽  
Camilo Molino Guidoni ◽  
Osvaldo de Freitas ◽  
Leonardo Régis Leira Pereira
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pharmaceutical Care ◽  
Care Service ◽  
Emergency Department Visits ◽  
Care Group ◽  
Control Group ◽  
Pharmaceutical Care Service

OBJECTIVE: To analyze the costs related to visits and drug prescription in outpatients with type 2 diabetes mellitus assisted by a pharmaceutical care service. SUBJECTS AND METHODS: A prospective and experimental study was carried out. Seventy one patients were divided into two groups: control and pharmaceutical care. Patients in the pharmaceutical care group were followed up monthly by a single clinical pharmacist. RESULTS: The pharmaceutical care group had a statistically significant reduction in costs of metformin and emergency department visits, and increased costs with their family physicians. On the other hand, the control group had a statistically significant increase of 21.3% in the general costs of treatment and visits. CONCLUSION: The pharmaceutical care group maintained the same costs related to drugs and visits, while the control group showed a significant increase in general costs.

scholarly journals Management of patients with type 2 diabetes mellitus in the Grand-Aides Program

2019 ◽  
Vol 10 (3) ◽  
pp. 1
Author(s):  
Rebekah M. Compton ◽  
Kimberly S. Bednar ◽  
Peggie E. Donowitz ◽  
M. Norman Oliver
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Emergency Department ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Diastolic Blood Pressure ◽  
Home Visit ◽  
Ed Visits

Objective: To evaluate the Grand-Aides Program for patients with type 2 diabetes mellitus (T2DM) according to the variables of body weight, blood pressure, medication adherence, and hospital consultation and readmissions.Methods: Patients ages 18 years or older with a past medical history of T2DM, hypertension (HTN), and/or obesity and who were recently seen in the emergency department (ED) or recently admitted to the hospital were eligible to enroll in the Grand-Aides Program. Eligible patients were identified after hospital or ED discharge and were asked to enroll in the in-home based program from March 2016 through June 2018. In-home visit protocol was defined prior to patient enrollment with intense in-home visits during the first weeks of enrollment followed by monthly visits for the duration of enrollment in the program. In-home visit frequency was adjusted on as needed basis so that patients at higher risk for ED visits or hospitalization were seen more frequently. In-home visits were performed by trained Grand-Aide who for the purpose of this study was a certified nursing assistant (CNA). The Grand-Aide underwent eighty hours of didactic training which included visit protocols, visit schedules, and data collection. The one-on-one in-home patient with every visit were supervised by a registered nurse (RN) or nurse practitioner (NP) via video or telephone contact near the conclusion of the visit. Active patients at the University of Virginia Family Medicine clinic were eligible for enrollment. Fifty-seven patients with T2DM worked with Grand-Aides for three months and an additional forty-eight T2DM patients worked with Grand-Aides for twelve months. Emergency department visits, all 30-day hospital readmissions, as well as blood pressure readings, medication adherence, weights, and glycated hemoglobin (HbA1c) were compared with the prior twelve months.Results: Systolic (p < .001) and diastolic (p < .01) blood pressures decreased (p < .01) at 1 year. At baseline 56 percent of the patients had a systolic blood pressure of >130 mmHg despite treatment; after 12 months, 48 percent of these were < 130. In those whose baseline diastolic blood pressure was > 90 mmHg, 100 percent had diastolic blood pressure < 90 mmHg at 1 year. Medication adherence by ARMS test at 1 year was 94 percent. Despite trending downward, weight and HbA1c did not change significantly. In the preceding, 58 percent had at least one ED visit, which was reduced by 50 percent (p < .01) with Grand-Aides; 30-day all-cause readmissions reduced by 50 percent to 6.3 percent. Conclusions: The Grand-Aides program was associated with a significant change in blood pressure control, high medication adherence and reductions in ED visits and readmissions that compare favorably with published comparative data. For systems “at risk” for preventable increased health care expense burden, the Grand-Aides program can result in significant savings.

Safe and Simple Emergency Department Discharge Therapy for Patients with Type 2 Diabetes Mellitus and Severe Hyperglycemia

2009 ◽  
Vol 15 (7) ◽  
pp. 696-704 ◽  
Author(s):  
Ambika Babu ◽  
Avinder Mehta ◽  
Pilar Guerrero ◽  
Zhen Chen ◽  
Peter Meyer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Emergency Department ◽  
Type 2 Diabetes Mellitus ◽  
Emergency Department Discharge

scholarly journals Hyperuricemia prevalence in Indian subjects with underlying comorbidities of hypertension and/or type 2 diabetes: a retrospective study from subjects attending hyperuricemia screening camps

2020 ◽  
Vol 8 (3) ◽  
pp. 794
Author(s):  
Himanshu Patel ◽  
Dhiren Shah
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medical Records ◽  
Disease Duration ◽  
Interventional Study ◽  
High Prevalence ◽  
Increasing Trend ◽  
Study Participants

Background: To determine the prevalence of HU in Indian subjects attending the HU screening camps and in subjects with type 2 Diabetes Mellitus (T2DM), Hypertension (HTN), and T2DM+HTN.Methods: This was a retrospective, non-interventional study where medical records of subjects attending HU screening camps across 592 locations in India, between June 2017 to May 2018, were analyzed.Results: A total of 197097 subjects (T2DM: 19.69%; HTN: 14.08%; T2DM+HTN: 21.60%) attended the screening camps. Mean age of the study participants was 48.43±13.38 years (Male: 53.80%). A total of 48606(24.66%) subjects had HU. In the overall population, a higher proportion of subjects with T2DM + HTN (7.36%) had HU in comparison to subjects with T2DM (5.63%) and HTN (4.25%) alone. Similar results were reported when the data was evaluated only in HU subjects (T2DM+HTN: 29.85%; T2DM: 22.82%; HTN: 17.22%). Proportion of HU subjects increased with age, with the maximum prevalence evident in subjects aged >50 years (12.94%), followed by 30-50 years (10.65%) and <30 years (1.07%). Gender-wise, a slightly higher proportion of males (14.13%) were found to be hyperuricemic than females (10.53%). Higher proportion of subjects with disease (T2DM and/or HTN) duration of 2-5 years were found to be hyperuricemic in comparison with subjects with disease duration of >5 years or <2 years. Similar results were reported when the data was evaluated in the overall HU subjects and by indication.Conclusions: Authors observed a high prevalence of HU among subjects attending HU camps and those with associated comorbidities. The prevalence of HU was higher in males and has an increasing trend with age. Furthermore, the prevalence of HU was observed to be higher in subjects with 2-5 years of duration of T2DM and/or HTN.

scholarly journals Severe Hemolysis With Negative Direct Antiglobulin Test: A Case Report

2021 ◽  
Author(s):  
Mahin Behzadi Fard ◽  
Ali Arianezhad ◽  
Ali Bandehzadeh
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Emergency Department ◽  
Type 2 Diabetes Mellitus ◽  
Total Bilirubin ◽  
Vital Signs ◽  
Direct Antiglobulin Test ◽  
Immune Mediated ◽  
Antiglobulin Test

Abstract A 49-year-old woman with type 2 diabetes mellitus presented to the emergency department. Her examination showed marked pallor, exhaustion, lethargy, yellowish eyes, anorexia, nausea and vomiting. Laboratory analysis revealed: Hemoglobin (Hb) 4.8 g/dl, MCV 91fl, platelet count 233 × 106 /L, Total bilirubin 7.0 mg/dl, Glucose 316 mg/dl, hematuria and normal G6PD. Hemolytic panel was unswerving with hemolysis. IV fluids and 2 units of packed cell were transfused. Despite transfusion, during the first 4 days of hospitalization the hemolysis continued so that immune hemolysis was suspected in spite of negative coomb's test. After 3 weeks of the patient refer to the hospital, she was discharged home with stable vital signs and Hb10 g/dl. Blood transfusion along with corticosteroids, IVIG and rituximab saved the life of this patient. We concluded in cases that presented with a severe drop in hemoglobin, even if there is a negative direct antiglobulin test (DAT) pay special attention to the immune mediated hemolysis and do not be misled with a negative coomb's test.

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